Fractional flow reserve derived from coronary CT angiography in stable coronary disease: a new standard in non-invasive testing?

Fractional flow reserve (FFR) measured during invasive coronary angiography is the gold standard for lesion-specific decisions on coronary revascularization in patients with stable coronary artery disease (CAD). Current guidelines recommend non-invasive functional or anatomic testing as a gatekeeper to the catheterization laboratory. However, the “holy grail” in non-invasive testing of CAD is to establish a single test that quantifies both coronary lesion severity and the associated ischemia. Most evidence to date of such a test is based on the addition of computational analysis of FFR to the anatomic information obtained from standard-acquired coronary CTA data sets at rest (FFR_CT). This review summarizes the clinical evidence for the use of FFR_CT in stable CAD in context to the diagnostic performance of other non-invasive testing modalities.

• Fractional flow reserve may be derived from standard coronary CT angiography (FFR _CT )

• FFR _CT provides high diagnostic performance in stable coronary artery disease